MEDICARE: MELISSA FOWLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	008088	GA

General Provider Information

NPI Number	:	1346172558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA FOWLER

Provider Business Mailing Address
First Line	:	3302 KAREN CT
Second Line	:
City	:	PHENIX CITY
State	:	AL
Zip	:	36867-2465
Country	:	US
Telephone Number	:	330-554-2686
Fax Number	:

Provider Business Practice Location Address
First Line	:	6896 RIVER RD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-2337
Country	:	US
Telephone Number	:	330-554-2686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ MELISSA FOWLER ” Practice Location

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